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1.  Comparative Study of Clinical and Radiological Outcomes of a Zero-Profile Device Concerning Reduced Postoperative Dysphagia after Single Level Anterior Cervical Discectomy and Fusion 
Objective
This study analyzed clinical and radiological outcomes of a zero-profile anchored spacer (Zero-P) and conventional cage-plate (CCP) for single level anterior cervical discectomy and fusion (ACDF) to compare the incidence and difference of postoperative dysphagia with both devices.
Methods
We retrospectively reviewed our experiences of single level ACDF with the CCP and Zero-P. From January 2011 to December 2013, 48 patients who had single level herniated intervertebral disc were operated on using ACDF, with CCP in 27 patients and Zero-P in 21 patients. Patients who received more than double-level ACDF or combined circumferential fusion were excluded. Age, operation time, estimated blood loss (EBL), pre-operative modified Japanese Orthopaedic Association (mJOA) scores, post-operative mJOA scores, achieved mJOA scores and recovery rate of mJOA scores were assessed. Prevertebral soft tissue thickness and postoperative dysphagia were analyzed on the day of surgery, and 2 weeks and 6 months postoperatively.
Results
The Zero-P group showed same or favorable clinical and radiological outcomes compared with the CCP group. Postoperative dysphagia was significantly low in the Zero-P group.
Conclusions
Application of Zero-P may achieve favorable outcomes and reduce postoperative dysphagia in single level ACDF.
doi:10.3340/jkns.2014.56.2.103
PMCID: PMC4200356  PMID: 25328646
Zero-profile; Prevertebral soft tissue swelling; Anterior cervical discectomy and fusion; ACDF; Dysphagia
2.  A Groove Technique for Securing an Electrode Connector on the Cranial Bone: Case Analysis of Efficacy 
Objective
A groove technique for securing an electrode connector was described as an alternative surgical technique in deep brain stimulation (DBS) surgery to avoid electrode connector-related complications, such as skin erosion, infection, and migration.
Methods
We retrospectively reviewed 109 patients undergoing one of two techniques; the standard technique (52 patients using 104 electrodes) and the groove technique (57 patients using 109 electrodes) for securing the electrode connector in DBS surgery, regardless of patient disease. In the standard percutaneous tunneling technique, the connector was placed on the vertex of the cranial surface. The other technique, so called the groove technique, created a groove (about 4 cm long, 8 mm wide) in the cranial bone at the posterior parietal area. Wound erosion and migration related to the connectors were compared between the two techniques.
Results
The mean follow-up period was 73 months for the standard method and 46 months for the groove technique. Connector-related complications were observed in three patients with the groove technique and in seven patients with the standard technique. Wound erosion at the connector sites per electrode was one (0.9%) with the groove technique and six (5.8%) with the standard technique. This difference was statistically significant. The electrode connector was migrated in two patients with the groove technique and in one patient with the standard technique.
Conclusions
The groove technique, which involves securing an electrode using a groove in the cranial bone at the posterior parietal area, offers an effective and safe method to avoid electrode connector-related complications during DBS surgery.
doi:10.3340/jkns.2014.56.2.130
PMCID: PMC4200360  PMID: 25328650
Deep brain stimulation; Connector; Complications
3.  Hemangiopericytoma of the Posterior Fossa: A Case Report and Review of the Literature 
Intracranial hemangiopericytoma is unusual, and those occurring in the posterior fossa is extremely rare; we report such a rare case of hemangiopericytoma of the posterior fossa. The radiologic findings and gross characteristics of hemangiopericytomas are sometimes quite similar to those of meningiomas. Although extremely rare, the operator should be aware of the existence of this disorder to dexterously manage the aggressive nature and high vascular tendency of hemangiopericytomas. The radiological features and histological findings in this case are discussed in this study.
doi:10.14791/btrt.2013.1.2.95
PMCID: PMC4027105  PMID: 24904899
Hemangiopericytoma; Posterior fossa; Meningioma
4.  Terson Syndrome Caused by Intraventricular Hemorrhage Associated with Moyamoya Disease 
Terson syndrome was originally used to describe a vitreous hemorrhage arising from aneurysmal subrarachnoid hemorrhage. Terson syndrome can be caused by intracranial hemorrhage, subdural or epidural hematoma and severe brain injury but is extremely rare in intraventricular hemorrhage associated with moyamoya disease. A 41-year-old man presented with left visual disturbance. He had a history of intraventicular hemorrhage associated with moyamoya disease three months prior to admission. At that time he was in comatose mentality. Ophthalmologic examination at our hospital detected a vitreous hemorrhage in his left eye, with right eye remaining normal. Vitrectomy with epiretinal membrane removal was performed. After operation his left visual acuity was recovered. Careful ophthalmologic examination is mandatory in patients with hemorrhagic moyamoya disease.
doi:10.3340/jkns.2012.51.6.367
PMCID: PMC3424178  PMID: 22949967
Moyamoya disease; Terson syndrome; Intraventricular hemorrhage
5.  Fusiform Aneurysm Presenting with Cervical Radiculopathy in Ehlers-Danlos Syndrome 
Ehlers-Danlos syndrome (EDS) type IV is characterized by its clinical manifestations, which are easy bruising, thin skin with visible veins, and rupture of arteries, uterus, or intestines. Arterial complications are the leading cause of death in vascular EDS because they are unpredictable and surgical repair is difficult due to tissue fragility. The authors report a case presented with cervical radiculopathy due to a segmental fusiform aneurysm of the cervical vertebral artery. Transfemoral cerebral angiography (TFCA) was done to verify the aneurysmal dilatation. However, during TFCA, bleeding at the puncture site was not controlled, skin and underlying muscle was disrupted and profound bleeding occurred during manual compression after femoral catheter removal. Accordingly, surgical repair of the injured femoral artery was performed. At this time it was possible to diagnose it as an EDS with fusiform aneurysm on cervical vertebral artery. Particularly, cervical fusiform aneurysm is rare condition, and therefore, connective tissue disorder must be considered in such cases. If connective tissue disorder is suspected, the authors suggest that a noninvasive imaging modality, such as, high quality computed tomography angiography, be used to evaluate the vascular lesion to avoid potential arterial complications.
doi:10.3340/jkns.2010.48.6.528
PMCID: PMC3053548  PMID: 21430980
Ehlers-Danlos syndrome; Cervical radiculopathy; Fusiform aneurysm; Vascular reconstruction

Results 1-5 (5)